Healthcare advocates forge ahead to revive Insure Tennessee

U.S. Rep. Jim Cooper addresses the crowd at a press conference at Saint Thomas Midtown Hospital on June 29, called by Insure Tennessee supporters to revive the plan to expand health insurance coverage to more Tennesseans. Photos by Theresa Laurence

Standing in the Saint Thomas Midtown Hospital auditorium in front of a giant screen that read “Nothing shall be impossible,” a variety of healthcare professionals and advocates, politicians and patients made a renewed push for state legislators to pass Insure Tennessee, a plan that would expand health insurance to as many as 280,000 of the state’s working poor.

Bolstered by the June 25 King v. Burwell U.S. Supreme Court decision, which upheld federal subsidies to keep health insurance premiums affordable regardless of whether the state or federal government runs the exchange system, Insure Tennessee advocates again made their case for expanding healthcare coverage in this state.

Pointing to the variety of patient advocates, business people and politicians sharing the stage with him at a press conference on June 29, Sen. Richard Briggs, R-Knoxville, said simply that “the reason we all support (Insure Tennessee) is because it’s the right thing to do.” Sen. Briggs, a surgeon and retired Army colonel, noted that Insure Tennessee would benefit veterans who do not qualify for benefits from the Veteran’s Administration.

The plan would also benefit the working poor, college students, and those with chronic illnesses. “When people understand who is in the gap, they support this plan,” said Michele Johnson, executive director of the Tennessee Justice Center, which helps vulnerable populations gain access to healthcare.

Introduced by Gov. Bill Haslam earlier this year, Insure Tennessee would have extended health insurance coverage to people living below the federal poverty level who are caught in Tennessee’s “coverage gap,” unable to qualify for TennCare, the state’s Medicaid program, or for subsidies to purchase insurance through the Affordable Care Act marketplace. However, the plan was twice defeated, first during a special session in February, then during the Legislature’s regular session in April.

But Insure Tennessee boosters are taking every opportunity to bring it back to the forefront. Nancy Anness, MSN, APN, BC, vice president of advocacy, access and community outreach for Saint Thomas Health, who attended President Barack Obama’s healthcare speech in Nashville on July 1, said that event was another opportunity to move the healthcare conversation forward.

Ahead of the speech, Anness said she hoped to hear Obama talk about “what we can do in Tennessee to take care of the least of these, and forge ahead in a renewal of Insure Tennessee.”

Karen Springer, president and chief operating officer of Saint Thomas Health, along with several other Saint Thomas representatives, also attended the president’s speech on the future of the Affordable Care Act, delivered at Taylor Stratton Elementary School in Madison.

Moving beyond politics

To build more support for Insure Tennessee, “I think the first step is to educate people,” said Johnson, of the Tennessee Justice Center.

She and other TJC staff members and volunteers are traveling across the state, meeting with people and collecting stories of those who could benefit from Insure Tennessee. Johnson attended the June 29 press conference with two TJC clients, Davy Crockett, (a direct descendent of “the real Davy Crockett,” he noted), who has Multiple Sclerosis and is unable to work, and Diane Donahue, who works part-time at a non-profit organization and doesn’t make enough to afford insurance and knows she’s “an emergency away from crippling medical debt.”

Insure Tennessee supporters applaud during a press conference in which healthcare providers, patient advocates and politicians encouraged the Tennessee State Legislature to pass the state’s Medicaid expansion program.

“We’re trying to de-politicize the issue by telling human stories,” said Johnson, a parishioner at Christ the King Church in Nashville. “What killed (Insure Tennessee) was not the merits of the program, but politics.”

Public opinion polls have shown that the majority of Tennesseans support Insure Tennessee, but the plan was twice voted down by a small minority of powerful state legislators before it could move out of committee.

Even though Haslam tried to make it clear that Insure Tennessee was, in fact, not “Obamacare,” it does depend on federal money, and with such distrust between state legislators and the federal government, the plan has been unable to gain traction. Many Republican lawmakers also disagree about the promised cost-neutrality of the program.

Haslam’s plan called for Insure Tennessee to run as a two-year pilot program to provide market-based health care coverage to more than 250,000 Tennesseans who currently don’t have access to health insurance or have limited options. “It does not create any new taxes for Tennesseans and will not add any state cost to the budget,” he said.

Under the Insure Tennessee plan, participants have co-pays and incentives for wellness and preventive care. “It’s not just giving away healthcare. It’s personal responsibility,” Anness said.

Although nothing about the Insure Tennessee proposal has changed in the months since lawmakers rejected it earlier this year, advocates remain convinced that it is the right, and necessary, thing to do.

“For our church, this is part of our mission, no question,” said Jennifer Murphy, executive director of the Tennessee Catholic Public Policy Commission, the public policy voice of the Catholic Church in Tennessee.

Expanding healthcare coverage is not only a moral issue, but also makes good business sense, several speakers at the Saint Thomas event noted. Without Insure Tennessee, independent rural hospitals are at risk of closing, which would leave vulnerable populations with less access to healthcare, and put medical and support staff out of work.

With more people insured, Saint Thomas could significantly reduce the estimated $70 million it provides in uncompensated care every year. It would also help people “get the right care at the right time in the right place,” said Anness. “We could give people a medical home and we wouldn’t have to keep doing medical missions.”

Passing Insure Tennessee “is important to us as a faith based ministry,” Anness said. “Until then, Saint Thomas will continue to serve all who need care, and welcome the least of these.”